Articulation/Speech sound disorders Flashcards

Question

Syllable structure pattern in which the final consonant is omitted

Answer 1

Final-consonant deletion

Answer 2

Epenthesis

Answer 3

1. Gender: More boys than girls tend to have SSDs 2. Intelligence: Not a strong factor/little evidence 3. Birth Order: Some evidence that firstborn/only children have better articulatory skills. Also, the greater the age, the better the articulatory skills. If one child has SSD and has sibling close to age, they may provide a model of inadequate articulation for the younger child 4. SES: Not a strong factor 5. Language dev.: Younger children with severe SSDs are more likely to demonstrate language problems than children with mild-moderate language delays 6. Auditory discrimination: Not a strong relationship/not enough evidence

Answer 4

No. Cutting the frenum used to be a common surgical procedure but research shows that children with ankyloglossia can have normal articulation. They may however have difficulty with the /t/ and /d/ as they are alveolar sounds.

Answer 5

Malocclusion I: Some individual teeth are misaligned. Malocclusion II: Overbite Malocclusion II: Underbite

Answer 6

Orofacial myofunctional disorders (OMD)

Answer 7

Oral myofunctional therapy

Answer 8

Dynamic Evaluation of Motor Speech Skill (DEMSS)

Answer 9

Very repetitive and structured. It involves increasing muscle tone and strength, increasing range of motion and treating other parameters (ex. respiration) that affect intelligibility Intensive and systematic drill, modeling, phonetic placement, and emphasis on accuracy of sound production.

Answer 10

To have the child produce words correctly spontaneously both inside and outside the clinic. The rationale for practicing a small set of functional words is that it will foster neural maturation of motor planning and programming substrates, which will in turn facilitate future speech motor learning

Answer 11

Yes. SLPs should use visual, auditory and tactile cues to teach treatment targets.

Answer 12

Nasals Plosives Fricatives Approximants Labials Linguals [b d m n] are the most frequently reported

Answer 13

[t] [d] and [w]

Answer 14

[ŋ] [k] [g] [w] [h]

Answer 15

plosives, nasals, fricative [h] and approximant [w]

Answer 16

Word-initial consonant clusters containing /w/ (e.g., [bw, kw]), where the target is [br, kl]

Answer 17

Common final consonant clusters for 2-3 year old children contain nasals [r] consonant clusters are rarely produced correctly by 2 year old children

Answer 18

Low, non-rounded vowels are favoured in the first year Front-back vowel differences appear later than height differences ^ other papers however have found that there is variability in what order vowels are acquired, but they are acquired early Number and diversity of vowels increases as children approach their second birthdays

Answer 19

By 5 years old, typically developing children should be understood most of the time, even to unfamiliar listeners. One study found that TD 3 year olds were 95.68% intelligible, 4 year olds were 96.82 intelligible, and 5 year olds were 98.05% intelligible to an unfamiliar listener

Answer 20

[p, b, t, d, k, g, m, n, ŋ, f, v, s, z, h, w, j, l, ʃ, , tʃ, dʒ, (ɹ)] Some studies have found that 3 year olds have acquired all major phoneme classes except for liquids

Answer 21

[p, b, t, d, k, g, n, ŋ, f, v, s, h, w, j, l, tʃ, dʒ, ɹ, ʒ, ʃ, ð, θ] Most studies indicate that 5 year old children produce over 90% of vowels, consonants, and consonant clusters correctly

Answer 22

Fewer occurring as children age Some we still see b/w ages 3-5, weak syllable deletion, final consonant deletion, cluster reduction, fronting, stopping, deaffrication, and gliding (WILL see fewer as kids get older, REFER TO CHART to see when each process should outgrown)

Answer 23

Ability to produce different stress patterns continues to develop Age 3, typically will master trochaic stress pattern (e.g., strong-weak stress patterns such as garden, and butterfly) Takes approximately 7 years to master words with non-final weak syllables in words (e.g., ambulance, caterpillar, computer, potato, vegetable)

Answer 24

Children who have speech difficulties that persist to the point when they need to use phonological skills for learning to read are at a high risk for reading problems

Answer 25

b/w 5-7 children start to lose their primary teeth Age 6 child’s skull reaches adult size Lower face grows from 7-10 Lips and tongue grow from 9-13 Mandible, lips, tongue grow until age 16 for girls and 18 for boys Throughout childhood and into adolescence refinement of movements of tongue tip, tongue body and jaw continue

Answer 26

5 syllables/ second on DDK task Sustain vowel ah for 10-11 seconds

Answer 27

Should be intelligible. Typically have all consonants and vowels and most consonant clusters with 90% accuracy Can produce all syllable shapes May still struggle with fricatives /v/, /th/ and /z/ and approimant /r/ are acquired later. Continuing to develop /s/ and/r/ blends. Mastery of complex prosody (used by adults) continues to develop in school years, even beyond age 10

Answer 28

Socioeconomic status: Inconclusive evidence. Some studies have found no difference in speech acquisition between groups of varying levels of SES. Other studies have found that children from higher SES households acquire speech earlier and have better phonological awareness skills. Maternal Education: Higher maternal but not paternal education has been linked to more advanced speech and language skills across many studies. Few studies however have considered this factor as it relates to speech acquisition and the results are mixed.

Answer 29

Word Frequency: Words occur in languages at different rates (i.e., high frequency or low) High frequency words → more likely to be accurate during speech acquisition, and may be better for facilitating progress in intervention. Age of Acquisition of Words: Some words are acquired earlier than others. The role of the age of acquisition speech accuracy is inconclusive. E.g., some studies find that voicing is learned with earlier acquired words, and others find the opposite. Clinical application: including later acquired words in intervention induces greater phonological generalization

Answer 30

Children vary in the number of words they know/use Bidirectional relationship b/w vocab size and speech accuracy Early speech production abilities drive word learning → as children learn more words, their speech improves. More words may mean more detailed underlying phonological representations.

Answer 31

The number of words that differ from a given word by one phoneme E.g., dense neighbourhoods have a lot of words that differ by one phoneme (e.g., “cat” has 35 neighbours) Words from dense neighbourhoods tend to be less variable in production in younger children Clinically unclear how to apply findings as there are benefits to including both types of words in intervention.

Answer 32

The likelihood of occurrence of a given sound or sound pair in a given language → thought to influence phonological representation. (e.g., “ca” in cat is more common than “cu” in cup) More common sound sequences tend to be learned more quickly and with greater accuracy during the course of typical speech development → however some contrasting evidence that this is not related with speech accuracy

Answer 33

How often a phoneme contrast with other phonemes in a language E.g., sounds with a high functional load = w, m, b, r, h, s, k, n, t b/c there are a lot of words that begin with these sounds. “Th” contrasts b/c not many words have this sound. Words with high functional loads tend to be acquired first.

Answer 34

The length and syllabic complexity of words influences children’s accuracy of speech production → simpler =easier Found across languages

Answer 35

How often a phoneme occurs in a language Example: very few words use “th” but the ones that are, are used frequently In general more frequently heard phonemes are learned earlier Phoneme input frequency can be offset though by other factors. E.g., “th”, b/c it has a lower functional load, and is more complex to articulate.

Answer 36

Pragmatic Factors: Children might avoid saying specific words/sounds because others have found their speech difficult to understand. This can be observed in typically developing children and clinically referred children. Might even avoid saying certain words upon Ax/Tx Personal Factors: Performance on a task may be impacted by the time of day, whether they are hungry, tired, bored, anxious, or disinterested in the task

Answer 37

Phonetic/Articulatory Complexity: How difficult a consonant is to produce from an artic perspective Kent (1992) proposed different levels of articulatory complexity: Level 1 (least complex/easy): [p, m, n, w, h] Level 2: [b, d, k, g, f, j ] Level 3: [t, r, l ] Level 4 (most complex): s, z, sh, d3, v, th (both)

Answer 38

Functional (no known cause) Organic (developmentally acquired): - Motor/neurological - structural - sensory/perceptual

Answer 39

Include those related to the motor production of speech sounds and those related to the linguistic aspects of speech production. Historically, these disorders are referred to as articulation disorders and phonological disorders, respectively.

Answer 40

Articulation disorders focus on errors (e.g., distortions, substitutions, addition or unusual idiosyncratic processes) in production of individual speech sounds

Answer 41

Focus on predictable, rule-based errors (e.g., fronting, stopping, and final consonant deletion) that affect more than one sound. It is often difficult to cleanly differentiate between articulation and phonological disorders; therefore, many researchers and clinicians prefer to use the broader term, “speech sound disorder,” when referring to speech errors of unknown cause

Answer 42

Dysarthria (execution): Don’t see too many of these Weakness or paralysis of speech musculature that affect respiration, phonation, articulation, and/or resonance Motor Speech Disorder-NOS Mixed signs of motor planning and subtle motor control difficulties but not enough to indicate a motor planning disorder or dysarthria Childhood Apraxia of Speech (planning): Very rare Difficulty executing the volitional motor plan for speech in the absence of paralysis

Answer 43

Cleft palate Structural deficits due to trauma or surgery

Answer 44

Hearing impairment.

Answer 45

Bilabial: p b Alveolar: t d Velar: k g

Answer 46

Bilabial: m Alveolar: n Velar: ŋ

Answer 47

Labiodental: f v Dental: θ ð Alveolar: s z Postalveolar: ʃ ʒ Glottal: h (voiceless)

Answer 48

postalveolar: t̬ʃ dʒ

Answer 49

Alveolar: r (voiced) Palatal: j (voiced) Velar: w (voiced)

Answer 50

alveolar: l (voiced)

Answer 51

Metathesis: occurs when two sounds or syllables in a word change places (e.g., ask → [æks]) Migration: only one sound moves within the word (e.g., snake → [neks]). Coalescence: occurs when two sounds in a word are replaced by a single sound, which has the features of the two replaced sounds but is neither of the original sounds. ex. An example is spoon → [fun]: the /f/ has the stridency of /s/ and the labial component of /p/ Reduplication: is the repetition of phonemes or syllables that young children demonstrate as a typical part of developing language (e.g., bottle → [baba] Epenthesis: the insertion of a sound. The most common form of epenthesis is the addition of /ə/ between two consonants in a cluster, such as black → /[balæk].

Answer 52

Tend to be less complex than TB but at a higher risk for speech delay. Glottal stops are used by some children to “mark” the final consonant in a word until the sounds are developed and often seen after repairs. Nasalized Vowels or ŋ/l Substitution→ Nasalized plosives or vowels can persist after surgical correction Nasalized /ɚ/ The final /ɚ/ Phoneme-specific nasal emission (PSNE) is the result of the use of either a pharyngeal or posterior nasal fricative as a substitution for other fricatives or affricates Pharyngeal Plosives are usually substituted for k/g

Answer 53

Adequate hearing is needed so that children are aware of the speech and language being used in their homes and surroundings. A hearing loss can affect the child’s ability to hear, which in turn may affect the acquisition of speech. Additionally, hearing is needed so that the children can monitor their speech as it is developing. The age of onset of a loss affects both speech and language acquisition. Children with severe/profound hearing losses since birth have a difficult time acquiring speech and language. If the hearing loss occurs later, the child may maintain some skills learned up to that point, but these skills typically deteriorate over time. Better language development is associated with early identification of hearing loss and early intervention

Answer 54

When intelligence falls into the cognitively delayed range (e.g., intelligence quotient [IQ] <70), however, there does tend to be a correlation: the lower the IQ, the higher the prevalence and frequency of speech sound errors

Answer 55

Children with SSDs are more likely to have difficulties with phonological awareness and literacy Critical age hypothesis: children who continue to have difficulties with SSD at the beginning of literacy instruction (around 5y old) are at most risk for having later literacy difficulties Lowered academic expectations and limitations on teacher child relationships Difficulty with initiation and maintenance of peer relationships, Increased parental anxiety and difficulty forming a nurturing parent child relationship Negative impact on sibling relationships Increased risk for reading difficulties and workplace difficulties Children whose speech errors interact with academic performance are more severely impacted (ie. /w/ for /r/ substitution error)

Answer 56

Appears to be a transfer between phonology from L1 to L2, and from L2 to L1. Cross-language associations among multilingual children are commonly known as cross-linguistic transfer. These effects can occur at the phonological, lexical–semantic, and morphosyntactic levels of language. Transfer effects between languages can be positive (facilitating language performance) or negative (impeding language performance), with the extent of transfer depending on how similar the languages are

Answer 57

Demographic information: Name, DOB, age, sex, address, phone, email address The family’s needs and concerns: Reason for the referral + other areas of concern Communication history: Babbling, first words, combining two words, current communication abilities, areas of concern, previous Ax and Tx from SLP, family Hx of speech, language, communication and academic difficulties Cultural and Language Hx: countries family has lived in. Languages spoken, competency in each language. See comprehensive language profile below for more details. Hearing Hx: number of ear infections & how they were treated, hearing tests, diagnoses, hearing aids, cochlear implants Birth Hx: pregnancy, significant birth events, gestation age at birth Developmental Hx: Milestones (sitting/walking), significant events during childhood Feeding & Eating: difficulties with breast feeding, bottle feeding, swallowing, food preferences and allergies The child and his/her environment: child’s interests, strengths, concerns, family members, friends, school, activities Family preferences: for Ax and Tx (e.g., service delivery, parent-caregiver roles)

Answer 58

Can be screened using the Intelligibility in Context Scale or rating scales provide quick screening measures of intelligibility, but there are disadvantages. Different listeners may make different judgements and specific intervention targets can’t be determined from the results. Single word Children produce a set of single words to assess intelligibility Examples: children’s speech intelligibility measure (CSIM), computer mediated single word intelligibility … more examples on page 248 Connected speech measures that quantify word and syllable identification Good face validity b/c judgements of speech intelligibility are more closely related to everyday conversational contexts Connected speech samples have mostly relied on sentence repetition & sentence reading Sentence reading not best measure b/c it’s dependent on how well the child can read (intelligibility can be impacted greatly –not valid) Intelligibility index: quantifies the number of words understood by the listener. Involves transcribing utterances and determining how many syllables are understood.

Answer 59

Example rating system: 0= within normal limits. Speech is normal 1= Mild: speech deviates from normal to a mild degree 2=Moderate: speech deviates from normal to a moderate degree. 3= Severe: speech deviates from normal to a severe degree.

Answer 60

Language profile. Intelligibility Acceptability Comprehensibility Stimulability Oral structure and function Hearing and speech perception Contextual testing Assessment of children's communication participation. Screening of language, voice, and fluency.

Answer 61

Substitution, omission, distortion, addition. SODA is the colloquial term for traditional articulation analysis, sorting speech errors in a sample by the four categories.

Answer 62

/s,z/ distortions with a lateral fricative across word-initial, within word, and word-final positions in both singletons and consonant clusters. Similar sounds may also be distorted.

Answer 63

Substitution of both th sounds for /s,z/ across word-initial, within word, and word-final positions in both singletons and consonant clusters.

Answer 64

It provides insight into what a child can produce regardless of the errors in their speech (independent analysis) and what children can correctly produce (relational analysis). Independent analysis has 3 components: A phonetic inventory Syllable inventory Shape inventory Relational Analysis primarily looks at phonological processes analysis.

Answer 65

Lexical: stress paterns in words, can be Sw (eg. paper), or wS (e.g. giraffe) Sentence: stress in connected speech Emphatic: emphasize a point.

Answer 66

Photography and video Acoustic analysis: spectrogram, wave form Ultrasound Nasometry MRI Electropalatography Speech video nasendoscopy Electromagnetic articulography

Answer 67

During speech, Non-speech tasks Feeding

Answer 68

Require children to discriminate between phonemes in isolation, syllables and words (can be real or nonsense) Auditory Discrimination same/different task: designed for CAS, where kids judge if two words sounds the same or different (e.g., lost vs lots) Note that children with CAS do well with real words (comparable to TD) but worse on nonsense words ABX task: listener hears 3 syllables, first 2 syllables are different, while the 3rd is identical to one of the first 2. Child picks which one they hear. Illegal vs Legal non-words: children listen to non-words comprising of phonotactically legal (plik) and illegal (pnik) syllable sequences –judge whether possible or impossible in the language they are learning.

Answer 69

Are designed to not only assess children’s abilities to detect differences between words but their ability to compare what they hear with their own stored representations of words. Can be completed with or without pictures A common example is contrastive minimal pairs Children point to a picture of one of the word pairs Words typically contain child’s error (e.g., ring vs. wing) Additional examples on pg 268 (too much detail for here)

Answer 70

Targets phonological pattern errors, designed for children with highly unintelligible speech with extensive omissions, some substitutions, and restricted use of consonants. Treatment is scheduled in cycles from 5-16 weeks in length, with one or more phonological patterns targeted. To facilitate efficient change in the child’s phonological systems, phonological patterns are targeted rather than individual phonemes. Good: better engagement due to frequent switching, used to stimulate emergence not mastery, evidence for improved intelligibility Bad: requires errorless learning, environment is a critical component, not appropriate for children that cannot sit and practice. Ex. Therapy may target FCD for 6 weeks, and then switch to target stopping of fricatives for the next 6 weeks, and then cycled once all phonological processes are targeted

Answer 71

Focuses on whole word production, and used with children with inconsistent speech sound production. Short list of target words is compiled and practiced in isolation, and then the child is free to play with toys as long as he/she will continue to converse with the therapist. If words come up in conversation, they are practiced with correct production. Good: good for children resistant to traditional approaches or with limited attention, slow progress or only say a few words due to speech issues. Bad: relies on words coming up naturally and ability to divide attention between word practice and play, lower repetition frequency.

Answer 72

Focuses on elements of phonemes that are lacking in a child’s repertoire. It uses minimal pairs that compare the phonetic elements/features of the target sound with those of its substitution or some other sound contrast. Good: used for children with substitution, often see generalization to other sounds that share targeted feature Bad: lack of updated evidence Ex. Distinctive features missing from the child’s repertoire may include frication, nasality, voicing, and place of articulation

Answer 73

Designed to teach metaphonological awareness - awareness of the phonological structure of language. Focus is on sound properties that need to be contrasted. Good: alerts to the properties of sounds, to show contrasts between sounds conveys meaning, and to facilitate knoledge of manipulating these features. Increases chance of contrastive sounds being understood. Bad: assumes children with phonological disorders have failed to acquire rules of phonological system. Ex. For problems with voicing, the concept of ‘noisy’ vs. ‘quiet’ is taught. Targets include processes that affect intelligibility, can be imitated, or are not seen in typically developing children of the same age.

Answer 74

Used to help a child acquire stable perceptual representation of the target phoneme or phonological structure. The goal is to ensure that the child is attending to the appropriate acoustic cues and weighting them accordingly to a language specific strategy. This approach includes auditory bombardment, sometimes in the context of a story, many varied target exemplars are presented to the child with amplification; and identification tasks. Good: computer tech has allowed for increased variability in stimuli presentation, opportunities for child to judge speech production of others. Bad: used in or before speech production training, not appropriate to administer in isolation, child must have accurate judgement abilities of self-production of sounds. Ex. In an identification task, the child identified correct and incorrect versions of the target (ie. ‘rat’ vs. ‘wat’) as presented by the clinician.

Answer 75

Group therapy can limit the number of doses in each intervention session - this reduces treatment intensity It is a poor choice for SSD unless the session length and number of sessions is increased In school environment, this may lead to frequent amounts of time outside of the classroom Emphasis on individual sessions so that each child can focus on their individual target sounds and spend minimal time outside of the classroom Children do not benefit from hearing other children produce their own target, they need to do so themselves Small group activities work for phonological awareness targets such as blending and segmenting

Answer 76

Role and preference of the family Service setting Frequency Formate (individual, group, parent, tele practice) Who is providing therapy When is it appropriate to change goals When is it appropriate to discharge

Answer 77

Senetory-perceptial (ear) training Prepractice instruction: learning to articulate sound Practice: isolation, nonsense syllables, words, sentences Transfer and carryover Maintenance